The increasing complexity of cancer chemotherapy makes it mandatory that pharmacists be familiar with these highly toxic agents. This column focuses on the commercially available and investigational agents used to treat malignant diseases and reviews issues related to the preparation, dispensing, and administration of cancer chemotherapy.
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References
1.
NCCN multiple myeloma practice guidelines.The Complete Library of NCCN Oncology Practice Guidelines [CD-ROM]. Version 2003. Rockledge, PA: National Comprehensive Cancer Network; 2003.
2.
AlexanianR., DimopoulosM.The treatment of multiple myeloma. N Engl J Med.1994; 330(7): 484–9.
3.
BarlogieB., SmithL., AlexanianR.Effective treatment of advanced multiple myeloma refractory to alkylating agents. N Engl J Med.1984; 310(21): 1353–6.
4.
EgererG., HegenbartU., SalwenderH.Outpatient treatment of multiple myeloma with a combination of vincristine, Adriamycin and dexamethasone. Support Care Cancer.2001; 9(5): 380–5.
5.
SampsonD., GaminaraE., NewlandA.Infusion of vincristine and doxorubicin with oral dexamethasone as first-line therapy for multiple myeloma. Lancet.1989; 2(8668): 882–5.
6.
CollinR., GreavesM., PrestonF.E.Potential value of vincristine–Adriamycin–dexamethasone combination chemotherapy (VAD) in refractory and rapid progressive myeloma. Eur J Haematol.1987; 39(3): 203–8.
7.
AbrahamsonG.M., BirdJ.M., NewlandA.C.A randomized study of VAD therapy with either concurrent or maintenance interferon in patients with newly diagnosed multiple myeloma. Br J Haematol.1996; (4):659–64.
8.
MonconduitM., Le LoetX., BernardJ.F.Combination chemotherapy with vincristine, doxorubicin, dexamethasone for refractory or relapsing multiple myeloma. Br J Haematol.1986; 63(3): 599–601.
9.
MonconduitM., MenardJ.F., MichauxJ.L.VAD or VMBCP in severe multiple myeloma. Br J Haematol.1992; 80(2): 199–204.
10.
WadhwaJ., KumarL., KochupillaiV.VAD followed by VMCP: An alternative regimen for multiple myeloma. Med Oncol.2002; 19(2): 105–8.
11.
AndersonH., ScarffeJ.H., RansonM.VAD chemotherapy as remission induction for multiple myeloma. Br J Cancer.1995; 71(2): 326–30.
12.
MineurP., MenardJ.F., Le LoetX.VAD or VMBCP in multiple myeloma refractory to or relapsing after cyclophosphamide-prednisone therapy (protocol MY 85). Br J Haematol.1998; 103(2): 512–7.
13.
SonneveldP., MarieJ.P., HuismanC.Reversal of multidrug resistance by SDZ PSC 833, combined with VAD (vincristine, doxorubicin, dexamethasone) in refractory myeloma. A phase I trial. Leukemia.1996; 10(11): 1741–50.
14.
GertzM.A., KalishL.A., KyleR.A.Phase III study comparing vincristine, doxorubicin (Adriamycin), and dexamethasone (VAD) chemotherapy with VAD plus recombinant interferon alfa-2 in refractory or relapsed multiple myeloma. An Eastern Cooperative Oncology Group study. Am J Clin Oncol.1995; 18(6): 475–80.
YoungR.I., RansonM., ChangJ.Phase II trial of rhIL-6 (interleukin-6) prior to and concurrently with VAD (vincristine, doxorubicin and dexamethasone) chemotherapy for patients with multiple myeloma. Eur J Cancer.1997; 33(2): 307–11.
17.
CornelissenJ.J., SonneveldP., SchoesterM.MDR-1 Expression and response to vincristine, doxorubicin, and dexamethasone chemotherapy in multiple myeloma refractory to alkylating agents. J Clin Oncol.1994; 12(1): 115–9.
18.
SonneveldP., SuciuS., WeijermansP.Cyclosporin A combined with vincristine, doxorubicin and dexamethasone (VAD) compared with VAD alone in patients with advanced refractory multiple myeloma an EORTC-HOVON randomized phase III study (06914). Br J Haematol.2001; 115(4): 895–902.
19.
BarlogieB., JagannathS., DesikanK.R.Total therapy with tandem transplant for newly diagnosed multiple myeloma. Blood.1999; 93(1): 55–65.
20.
KarsA., CelikI., KansuE.Maintenance therapy with alpha-interferon following first-line VAD in multiple myeloma. Eur J Haemtol.1997; 59(2): 100–4.
21.
PhillipsJ.K., Sherlaw-JohnsonC., PearceR.A randomized study of MOD versus VAD in the treatment of relapsed and resistant multiple myeloma. Leuk Lymphoma.1995; 17(5-6): 465–72.
22.
LejeuneC., SottoJ.J., FuzibetJ.G.Alternating combination of alkylating agents and vincristine, doxorubicin, and dexamethasone in multiple myeloma. J Clin Oncol.1991; 9(6): 1090–1.
23.
AlexanianR., BarlogieB., TuckerS.VAD-based regimens as primary treatment for multiple myeloma. Am J Hematol.1990; 33(2): 86–9.
24.
HusseinM.A., WoodL., HisE.A Phase III trial of pegylated liposomal doxorubicin, vincristine, and reduced-dose dexamethasone combined therapy in newly diagnosed multiple myeloma patients. Cancer.2002; 95(10): 2160–8.
25.
BrowmanG.P., BelchA., SkillingsJ.Modified Adriamycin–vincristine–dexamethasone (m-VAD) in primary refractory and relapsed plasma cell myeloma: An NCI (Canada) pilot study. Br J Haematol.1992; 82(3): 555–9.
26.
SegerenC.M., SonneveldP., van der HoltB.Vincristine, doxorubicin, and dexamethasone (VAD) administered as rapid intravenous infusion for first-line treatment in untreated multiple myeloma. Br J Haematol.1999; 105(1): 127–30.
27.
DimopoulosM.A., PouliA., ZervasK.Prospective randomized comparison of vincristine, doxorubicin and dexamethasone (VAD) administered as intravenous bolus injection and VAD with liposomal doxorubicin as first-line treatment in multiple myeloma. Ann Oncol.2003; 14(7): 1039–44.
28.
StenzingerW., BlomkerA., HiddemannW.Treatment of refractory multiple myeloma with the vincristine–Adriamycin–dexamethasone (VAD) regimen. Blut.1990; 61(2-3): 55–9.
29.
TrisselL.A.Handbook on Injectable Drugs.11th ed.Bethesda, MD: American Society of Health-System Pharmacists; 2003, 486, 1373, 1378.
30.
HeskethP.J., KrisM.G., GrunbergS.M.Proposal for classifying the acute emetogenicity of cancer chemotherapy. J Clin Oncol.1997; 15(1): 103–9.
31.
American Society of Health-System Pharmacists.ASHP therapeutic guidelines on the pharmacologic management of nausea and vomiting in adult and pediatric patients receiving chemotherapy or radiation therapy or undergoing surgery. Am J Health Syst Pharm.1999; 56: 729–64.
32.
NCCN antiemesis practice guidelines.The Complete Library of NCCN Oncology Practice Guidelines [CD-ROM]. Version 2003. Rockledge, PA: National Comprehensive Cancer Network; 2003.
33.
GrallaR.J., OsobaD., KrisM.G.Recommendations for the use of antiemetics: Evidence-based, clinical practice guidelines. J Clin Oncol.1999; 17(9): 2971–94.
OzerH., ArmitageJ.O., BennettC.L.2000 update of recommendations for the use of hematopoietic colony-stimulating factors: Evidence-based, clinical practice guidelines. J Clin Oncol.2000; 18(20): 3558–85.
LymanG.H., KudererN., GreeneJ.The economics of febrile neutropenia: Implications for the use of colony-stimulating factors. Eur J Cancer.1998; 34(12): 1857–64.
38.
LymanG.H., BalducciL.Update of the economic analyses of the use of colony stimulating factors. Curr Opin Hematol.1999; 6(3): 145–51.
39.
LymanG.H.A novel approach to maintain planned dose chemotherapy on time: A decision-making tool to improve patient care. Eur J Cancer.2000; 36(suppl 1): S15–S21.
40.
LarsonD.L.Treatment of tissue extravasation by antitumor agents. Cancer.1982; 49: 1796–9.
41.
LarsonD.L.What is the appropriate management of tissue extravasation by antitumor agents?Plast Reconstr Surg.1985; 75: 397–402.
42.
MullinS., BeckwithM.C., TylerL.S.Prevention and management of antineoplastic extravasation injury. Hosp Pharm.2000; 35: 57–74.
43.
KitzelP.E., DorrR.T.Anticancer drug renal toxicity and elimination. Dosing guidelines for altered renal function. Cancer Treat Rev.1995; 21: 33–64.
44.
KingP.D., PerryM.C.Hepatotoxicity of chemotherapeutic and oncologic agents. Gastroenterol Clin North Am.1995; 24: 969–89.
